11D1107416 CLIA NUMBER - EMORY DIALYSIS AT NORTHSIDE

Laboratory Demographics

  • CLIA Code: 11D1107416
  • Facility Name: EMORY DIALYSIS AT NORTHSIDE
  • Facility Address: 610 NORTHSIDE DRIVE NW
    ATLANTA, GA
    ZIP 30318
  • Facility Phone: 336 748-0575
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: JANIE LEA MD
  • NPI Number: 1013142843
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D1107416
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name EMORY DIALYSIS AT NORTHSIDE
Street 610 NORTHSIDE DRIVE NW
City ATLANTA
State GA
ZIP 30318
Phone 336 748-0575
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/5/2023
Certificate Expiration Date 11/4/2025
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director JANIE LEA MD

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This page was last updated on: 9/29/2025